Sometimes, what goes up comes down the hard way. Reducing falls from ladders means making sure even seasoned workers follow the rules.

Falls cause approximately one-third of all construction accidents, and that statistic includes ladder-related accidents. Among construction workers, an estimated 81 percent of fall injuries treated in emergency rooms involve a ladder.

What would cause an experienced constructor worker to succumb to such an accident? The Harvard School of Public Health conducted a study on the safety of portable ladders used in construction. It found the main causes of falls from portable ladders were:

40 percent: The ladder moved

24 percent: A foot missed a step or slipped

18 percent: The worker lost balance

In 4 percent of cases, the ladder broke, and in another 4 percent, the person was struck by an object.

The keep your workers safer when they use ladders, provide the proper training and ensure that everyone follows these precautions:

Choose the right ladder. Ladders are classified as fixed or portable. A fixed ladder is attached to a structure, providing, for example, long-term access to rooftop mechanical systems for maintenance crews.

A portable ladder, which can be carried from place to place, is the type most likely to be found on a construction site. Choices include stepladders, straight ladders, extension ladders, platform ladders (for two-handed tasks) and tripod ladders (for work in corners and next to stationary objects).

Another consideration is the material the ladder is made of. Metal ladders don’t mix well with electrical work or power lines. But a metal ladder might be better (assuming there are no electrical hazards nearby) in areas of high moisture where wood ladders can decay.

Maximum weight capacity, aka duty rating, is another factor. Ladders are manufactured with certain end uses in mind. So, for example, a worker who intends to use a platform ladder to perform ceiling repairs must make sure the duty rating is adequate for his or her clothed weight plus any tools, supplies or equipment.

Inspect for damage before use. Any ladders that are not in good working condition should be removed from service until they can be repaired. Some inspection pointers:

Check for loose or missing rungs, bolts, nails or screws.

Make sure the non-skid feet are intact and not worn.

Check stepladders for wobble and damage to hinges.

Check wood ladders for signs of rot and metal ladders for rust or corrosion.

Use ladders properly. Here is just a sampling of OSHA regulations that dictate how workers must use ladders:

Place a ladder one-quarter of its working length away from the supporting wall.

Do not place the ladder on unstable ground or atop materials or debris.

When using a ladder for roof access, the ladder must extend at least 3 feet above the roof's surface.

Always keep at least one hand on the ladder. It’s smart to maintain three points of contact — two hands and a foot or two feet and a hand.

Never climb higher than the third rung from the top of an extension/straight ladder or higher than the second tread from the top of a stepladder.

Do not use a metal ladder within 10 feet of electricity.

Never try to “walk” a ladder into a new position while on it.

Ladder rules are straightforward, so why are ladder violations number seven on OSHA's 2016 list of the most common safety violations?

One possibility is that workers don't understand the reasons for the rules. Unless the company devotes time to training and driving home the ramifications of unsafe practices, employees might even resent having to follow them.

Another is that production pressure could lead employees and even supervisors to ignore dangerous practices for the sake of speed. As long as no one gets hurt, the thinking goes, it's “no harm no foul.”

But people do get hurt, as the data show. The solution? Vigilance, accountability, training and a workplace culture that emphasizes worker well-being are all steps to a higher plane of safety.